Dynamic MRI in a COVID-19 patient: a case series

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Abstract

Extensive spread of the coronavirus disease (COVID-19) prompted an investigation of its diagnostic features. Acute viral pneumonia associated with COVID-19 has been described in detail using CT, radiography, and MRI. There is no data in the literature on the descriptive picture observed with dynamic MRI. Considering a comprehensive diagnostic approach, radiologists should know how to correctly recognize and interpret COVID-19 on MRI. This case series demonstrated the ability of dynamic MRI to detect the cloudy sky sign and distinguish it from consolidation in COVID-19 patients, thus presumably distinguishing between early or mild changes and a progressive clinical course. These changes in dynamic lung images on MRI can be recorded depending on the phase of the respiratory cycle. Thus, MRI, as a radiation-free tool that can be used to examine a patient with acute viral pneumonia COVID-19, can be useful in cases where access to computed tomography is limited and dynamic morphofunctional imaging is required.

About the authors

Yuriy A. Vasilev

Moscow Center for Diagnostics and Telemedicine

Email: y.vasilev@npcmr.ru
ORCID iD: 0000-0002-0208-5218
SPIN-code: 4458-5608

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Evgeniia A. Grik

Lincoln Medical Center

Email: evgeniyagrik@gmail.com
ORCID iD: 0000-0002-7908-3982
SPIN-code: 5558-7307
United States, The Bronx, NY

Olga Yu. Panina

Moscow Center for Diagnostics and Telemedicine; City Clinical Oncological Hospital 1 of the Department of healthcare of the city of Moscow; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: o.panina@npcmr.ru
ORCID iD: 0000-0002-8684-775X
SPIN-code: 5504-8136
Russian Federation, Moscow; Moscow; Moscow

Anna N. Khoruzhaya

Moscow Center for Diagnostics and Telemedicine

Author for correspondence.
Email: a.khoruzhaya@npcmr.ru
ORCID iD: 0000-0003-4857-5404
SPIN-code: 7948-6427
Russian Federation, Moscow

Dmitriy S. Semenov

Moscow Center for Diagnostics and Telemedicine

Email: d.semenov@npcmr.ru
ORCID iD: 0000-0002-4293-2514
SPIN-code: 2278-7290
Russian Federation, Moscow

Alexander V. Bazhin

Moscow Center for Diagnostics and Telemedicine

Email: a.bazhin@npcmr.ru
ORCID iD: 0000-0003-3198-1334
SPIN-code: 6122-5786
Russian Federation, Moscow

Yulia N. Vasileva

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: drugya@yandex.ru
ORCID iD: 0000-0002-1066-3989
SPIN-code: 9777-2067

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

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Supplementary files

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2. Figure 1. Dynamic magnetic resonance imaging of the lungs during inhalation in the coronal, axial, and sagittal planes. In the axial and sagittal planes, arrows point to areas of compaction. In the coronal plane, the arrow points to a “cloudy sky” (S9–S10).

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3. Figure 2. Dynamic magnetic resonance imaging of the lungs during exhalation in the coronal, axial, and sagittal planes. Arrows indicate the areas of consolidation (S9–S10).

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4. Figure 3. Dynamic magnetic resonance imaging of the lungs during inhalation in the coronal, axial, and sagittal planes. Orange arrows point to consolidation areas visible during inhalation (S6, S8, and S9). The white arrow points to the area with the “cloudy sky.”

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5. Figure 4. Dynamic magnetic resonance imaging of the lungs during exhalation in the coronal, axial, and sagittal planes. Arrows point to lesions with areas of both marked interstitial changes (the sign of the “cloudy sky”) and alveolar (compaction) changes that can be differentiated during inhalation (see Figure 3).

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6. Figure 5. Dynamic magnetic resonance imaging of the lungs during inhalation in the coronal, axial, and sagittal planes. Arrows point to areas of low-intensity signal with the “cloudy sky” pattern (S6, S9, and S10).

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7. Figure 6. Dynamic magnetic resonance imaging of the lungs during exhalation in the coronal, axial, and sagittal planes. Arrows point to an increase in low-intensity signal areas with the “cloudy sky” pattern (S6, S9, and S10).

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